Restoring the Balance: Women Physicians and the Profession of Medicine, 1850-1995 (review)

Ellen S. More. Restoring the Balance: Women Physicians and the Profession of Medicine, 1850-1995. Cambridge: Harvard University Press, 1999. xi + 340 pp. Ill. $49.95.

The theme of balance that Ellen More weaves throughout her book has at least two connotations. The first is the difficulty women physicians have had in balancing their career with their personal life: is it possible to excel in the one without short-changing the other? The second is the challenge of balancing difference with equality: can a woman physician be equal to a man physician and yet still be different from him? In order to cope with the magnitude of these questions over the time period covered, More chooses specific people and organizations on which to focus.

Dr. Sarah Adamson Dolley represents the pioneering generation of women physicians. According to More, Dolley's career "epitomized those of many of her generation and set a pattern for even more of her twentieth-century successors, women physicians who strove to balance the demands of personal and professional, private and public life, to reconcile femininity, feminism, and professionalism" (p. 41). While this may have been Dolley's intent, in some respects her life choices worked against it. For example, she did not seem to have a particularly close relationship with her son, and indeed sent him away to boarding school--which suggests an inability to balance career with family life.

More's second chapter addresses how women, once they became physicians, were able to survive as individuals and as practitioners. She examines the professional organizations women physicians created, which provided space for them to communicate with one another and encouraged their professional development. This and subsequent chapters emphasize the separatist aspects of medical practice by women physicians--that is, their focus on women and children, and their sense of feminine solidarity. It would be interesting to know how widespread this perception was: how did male physicians perceive this "solidarity"?

By the end of the First World War, however, the women's sphere of medical practice was disappearing. As chapter 4 argues, the rise of professionally run hospitals, the growth of specialties, and postgraduate residencies opened up more career opportunities and with them the focus of women physicians shifted--but at a price. Women entering medical schools could no longer look to a women's medical community that could mentor and help them in their careers. It is in delineating the impact of professionalized hospitals that More exposes the "new" barriers faced by the second and third generations of women physicians. This period is generally overlooked by many historians of medicine, who prefer to exalt the first generation. Yet those who came after had, in some respects, a more difficult task. For them, the barriers were more covert, not always spelled out, seldom uniform, but nevertheless firm. As a result, more often than not these women remained on the margins of the profession, outsiders to the major medical organizations, and confined to less-prestigious specialties.

Chapter 5 follows their efforts to break down the barriers. Two organizations epitomized those efforts: the Medical Women's National Association, founded in 1915, and the American Women's Hospitals service, organized in 1917 to provide wartime opportunities to women physicians who were formally prohibited from joining the military reserves. The postwar period is represented by the rise and fall of the Sheppard-Towner Act, the decline of medical maternalist ideology, and the careers of a few women who were able to carve out a professional niche for themselves. World War II saw the successful opening of the Army Medical Reserves to women physicians, but was immediately followed by the push for a return to normality. The book ends with the eventual reaction against the concept of "separate spheres" as epitomized by the women's movement of the 1960s and resultant legislation enforcing equal...